Talent.com
Director, Inpatient System Care Management
Director, Inpatient System Care ManagementAlameda Health System • Oakland, CA, US
Director, Inpatient System Care Management

Director, Inpatient System Care Management

Alameda Health System • Oakland, CA, US
15 hours ago
Job type
  • Full-time
Job description

Summary

Alameda Health System offers outstanding benefits that include :

  • 100% employer health plan for employees and their eligible dependents
  • Unique benefit offerings that are partially or 100% employer paid
  • Rich and varied retirement plans and the ability to participate in multiple plans.
  • Generous paid time off plans

Role Overview :

Alameda Health System is hiring! Under the direction of the Vice President of Care Management, the Director of Inpatient System Care Management manages the day-to-day operations of the inpatient Care Management across all AHS facilities, including post-acute care facility for ensuring efficient patient flow, beginning when a patient is admitted to the facility and ending with a safe and clinically appropriate discharge.

DUTIES & ESSENTIAL JOB FUNCTIONS : NOTE : The following are the duties performed by employees in this classification. However, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

  • Accountable for Patient Care Coordination activities including system-wide Case Management, Care Coordination and Discharge Planning.
  • Aligns Case Management with AHS strategic and operational objectives.
  • Optimizes efficient care management / care coordination roles and processes, initiates process improvements.
  • Develops, monitors and evaluates inpatient Care Management Metrics; manages the collection, analysis and presentation data relevant to the utilization of healthcare resources, including but not limited to avoidable / variance days, readmissions, one-day stays, DRGs, LOS.
  • Develops, maintains and implements Case Management policies, practices and procedures in accordance with CMS, CA DCHS, the Joint Commission, Title 22 and other regulatory agencies and overall hospital policies; integrates managed care contract criteria into overall Case Management functions.
  • Works closely with the VP of Care Management and Physician Advisors on any audits and secondary reviews; may include but not limited to direct and coordinate data gathering, chart audits and participants in internal and external meetings.
  • Oversees educational needs and plan for inpatient Care Management division.
  • Recruits, trains and coaches the management staff to assist them with performing optimally and provides appropriate discipline / structure; consults and assists Care Management managers with problem-solving with staffing, personnel issues, budget issues and resource management; reviews and evaluates management staff performance, initiates personnel transactions and meets hospital standards for performance evaluations.
  • Supports the VP of CM with completion of financial analyses including cost of care to reimbursement, denials management, and non-reimbursed services, promoting effective resource utilization, clinical documentation / queries, quality care and patient safety; oversees the inpatient recovery process; works closely with Revenue Cycle and AHS Physician Advisors; regularly communicates with payors and / or their contracted vendors.
  • Responsible for the coordination and support of the AHS Utilization Review Committee.
  • Responsible for overseeing patient, physician and staff satisfaction based on quality outcomes and patient experience reporting; in conjunction with the Quality Leadership, identifies utilization issues affecting the quality of patient care.
  • Provides AHS physicians, nursing and staff education including InterQual® criteria methodology, resource management, medical necessity guidelines, payer sources, clinical outcome metrics, length of stay initiatives, readmission strategies, reimbursement rules and medical record documentation requirements.
  • Serves as Content Expert / Liaison to community agencies, AHS and Non AHS primary care provider network and all AHS stakeholders across all AHS facilities (i.e. Nursing and Hospital Administrators) for provision of care and services across the continuum of care.
  • In conjunction with department managers and / or supervisors coordinates, develops, and implements action plans to respond to areas felt to be in need of improvement related to patient flow and care coordination across the continuum.
  • Assumes accountability for improving utilization metrics associated with department / unit and meeting organizational / departmental targets.
  • Evaluates, plans, and executes changes in department procedures, equipment and supplies.
  • Performs all other duties as assigned.
  • MINIMUM QUALIFICATIONS :

  • Required Education : Master's degree in Nursing or Master's degree in Social Work or related field.
  • Required Experience : Seven to ten years of case management or quality experience in addition to progressive management experience in a large healthcare organization is required.
  • Preferred Experience : N / A
  • Required Licenses / Certifications : Active licensure as a Registered Nurse in the State of California or valid license as a Clinical Social Worker issued by the State of California Board of Behavior Science Examiners; active BLS - Basic Life Support Certification issued by the American Heart Association; CPI -Crisis Prevention Intervention Training; Other advanced life support certifications may be required per unit / department specialty according to patient care policies.

    Preferred Licenses / Certifications : Certification in Case Management, CCMC or ACM.

    Highland General Hospital

    SYS Care Coordination

    Full Time

    Varies

    Management

    FTE : 1

    Create a job alert for this search

    Director Care Management • Oakland, CA, US

    Related jobs
    Director of Enhanced Care Management

    Director of Enhanced Care Management

    VirtualVocations • Oakland, California, United States
    Full-time
    A company is looking for a Director of Enhanced Care Management.Key Responsibilities Direct and oversee operations of the enhanced care management program Supervise Clinical Managers, Clinical C...Show more
    Last updated: 2 days ago • Promoted
    Director of Patient Support

    Director of Patient Support

    VirtualVocations • Santa Clara, California, United States
    Full-time
    A company is looking for a Director of Patient Support to lead a high-performing team responsible for patient engagement and retention. Key Responsibilities Build and inspire a team of Patient Sup...Show more
    Last updated: 1 day ago • Promoted
    Director of Reimbursement

    Director of Reimbursement

    VirtualVocations • Fremont, California, United States
    Full-time
    A company is looking for a Director of Reimbursement (Remote).Key Responsibilities Oversee government payor reporting and ensure timely filing of cost reports Manage invoicing and compliance for...Show more
    Last updated: 2 days ago • Promoted
    Manager of Care Navigation

    Manager of Care Navigation

    VirtualVocations • Fremont, California, United States
    Full-time
    A company is looking for a Manager, Care Navigation to lead and grow their Patient Care Specialist team.Key Responsibilities Lead, coach, and develop a high-performing Patient Care Specialist tea...Show more
    Last updated: 1 day ago • Promoted
    Director Of Clinical Services

    Director Of Clinical Services

    Acadia Healthcare • San Jose, CA, US
    Full-time
    San Jose Behavioral Health is a 133-bed inpatient psychiatric hospital serving adolescents and adults facing mental health and co-occurring substance use challenges. Our mission is to provide compas...Show more
    Last updated: 30+ days ago • Promoted
    Director of Product, Care Connections

    Director of Product, Care Connections

    Grow Therapy • San Francisco, CA, United States
    Full-time
    Director of Product, Care Connections.Director of Product, Care Connections.Grow Therapy is on a mission to serve as the trusted partner for therapists growing their practice, and patients accessin...Show more
    Last updated: 30+ days ago • Promoted
    Senior Director, Patient Services

    Senior Director, Patient Services

    Ardelyx • Fremont, CA, United States
    Full-time
    Ardelyx is a publicly traded commercial biopharmaceutical company founded with a mission to discover, develop and commercialize innovative first-in-class medicines that meet significant unmet medic...Show more
    Last updated: 15 days ago • Promoted
    Director of Revenue Cycle Management

    Director of Revenue Cycle Management

    VirtualVocations • Santa Clara, California, United States
    Full-time
    A company is looking for a Director of Revenue Cycle Management to lead all aspects of the revenue cycle for a telehealth healthcare practice. Key Responsibilities Lead the end-to-end revenue cycl...Show more
    Last updated: 30+ days ago • Promoted
    Patient Access Manager

    Patient Access Manager

    VirtualVocations • Hayward, California, United States
    Full-time
    A company is looking for a Manager, Patient Access to lead and grow their Patient Care Representatives.Key Responsibilities Lead, coach, and develop a high-performing Patient Access team to deliv...Show more
    Last updated: 1 day ago • Promoted
    Clinical Director - Mental Health 321

    Clinical Director - Mental Health 321

    Telecare Corporation • Martinez, CA, United States
    Full-time
    They made it easier for me to live, breathe, eat, and stay clean.Without them, I'd be waiting somewhere, waiting for someone to give me a chance to live. Client from Orange County Region.Telecare's ...Show more
    Last updated: 21 days ago • Promoted
    DIRECTOR OF BUSINESS DEVELOPMENT -(DBD) - WEST REGION

    DIRECTOR OF BUSINESS DEVELOPMENT -(DBD) - WEST REGION

    Compass Group USA • San Francisco, CA, United States
    Full-time
    DIRECTOR OF BUSINESS DEVELOPMENT -(DBD) - WEST REGION.Be among the first 25 applicants.Get AI-powered advice on this job and more exclusive features. Retrieved from the description.Salary : $110,000-...Show more
    Last updated: 3 hours ago • Promoted • New!
    State Licensed Patient Care Director

    State Licensed Patient Care Director

    VirtualVocations • San Francisco, California, United States
    Full-time
    A company is looking for a Director, Patient Care to lead and evolve their Care Navigation and Clinical teams.Key Responsibilities Lead and develop a high-performing Patient Care organization Es...Show more
    Last updated: 1 day ago • Promoted
    Senior Director of Value-Based Care

    Senior Director of Value-Based Care

    VirtualVocations • Santa Clara, California, United States
    Full-time
    A company is looking for a Senior Director of Value-Based Care, VBC - Data and Analytics.Key Responsibilities Lead quantitative research and analysis to provide actionable recommendations for VBC...Show more
    Last updated: 2 days ago • Promoted
    Senior Manager, Digital Enterprise Capabilities (DEC) Clinical Systems Operations (Remote)

    Senior Manager, Digital Enterprise Capabilities (DEC) Clinical Systems Operations (Remote)

    Jazz Pharmaceuticals • Palo Alto, CA, United States
    Remote
    Full-time
    If you are a current Jazz employee please apply via the Internal Career site.Jazz Pharmaceuticals is a global biopharma company whose purpose is to innovate to transform the lives of patients and ...Show more
    Last updated: 11 days ago • Promoted
    Director, Clinical Supplies

    Director, Clinical Supplies

    Dynavax Technologies • Emeryville, CA, United States
    Full-time
    This position can be 100% remote, but must be located in the United States.Dynavax is a commercial-stage biopharmaceutical company developing and commercializing novel vaccines to help protect the ...Show more
    Last updated: 17 days ago • Promoted
    Director of Engineering Integrations

    Director of Engineering Integrations

    VirtualVocations • Fremont, California, United States
    Full-time
    A company is looking for a Director of Engineering Integrations who can lead and implement technical integrations across the pharmacy ecosystem. Key Responsibilities Own the end-to-end technical i...Show more
    Last updated: 1 day ago • Promoted
    Senior Director of Client Analytics

    Senior Director of Client Analytics

    VirtualVocations • Concord, California, United States
    Full-time
    A company is looking for a Senior Director Client Reporting and Analytics.Key Responsibilities Develop and execute the customer reporting strategy aligned with business priorities and market need...Show more
    Last updated: 30+ days ago • Promoted
    Director, Clinical Operations

    Director, Clinical Operations

    Jade Biosciences • San Francisco, CA, United States
    Temporary
    Boston, Massachusetts, United States; San Francisco, California, United States; Seattle, Washington, United States.Jade Biosciences is focused on developing innovative, best-in-class therapies to a...Show more
    Last updated: 2 days ago • Promoted